Aspirin: Turn of the Century Miracle Drug

According to the theory concerning the origin of the name aspirin, it comes from the combination of acetyl; the Latin Spiraea, the genus of plants to which meadowsweet belongs and which also contains salicylic aldehyde, a precursor to salicylic acid (in German salicylic acid is Spirsäure); and -in, which was a common ending for drug names at the time. Although the company name Bayer has long been associated with aspirin, after World War I, Bayer lost the sole right to use the name aspirin. It was acquired in 1919 by Sterling Incorporated for the then unheard-of price of $3 million, along with Bayer’s U.S. drug properties. Eventually Bayer reacquired the trademark from SmithKline Beecham as part of a wider deal, for the price of $1 billion.

The first tablet form of aspirin appeared in 1900, creating an ease of use that quickly expanded the drug’s recognition among professionals. Medical reports highlighted the benefits of aspirin, and its popularity reflected the already significant use of salicylic compounds, coupled with the fact that this new drug was considerably safer and comparably less toxic. In 1915 aspirin became available to the public without a prescription, making it arguably the first modern, synthetic, over-the-counter, mass-market medicine and a household name around the world.

By providing an easy and inexpensive method to alleviate pain, aspirin began to change the experience and expectations of patients and doctors and ultimately the nature of modern medicine itself. Before the mid-1800s Western physicians had considered pain an essential diagnostic tool, something that aspirin alleviated and thus disguised. Doctors would now have to look to other symptoms.

It was not until 1971 that scientists began to understand how aspirin worked in the body as an anti-inflammatory agent—what is now referred to as a nonsteroidal anti-inflammatory drug (NSAID). John Robert Vane, a British pharmacologist, and his graduate student Priscilla Piper performed pioneering work on aspirin, exploring the effects of the drug on isolated lungs from guinea pigs and studying the effects of substances released from the lungs during severe allergic reactions to aspirin. During these studies the scientists identified two uncharacterized substances, one of which turned out to be a prostaglandin—a hormone-like compound involved in causing diverse effects in the body, including vasodilation, vasocontraction, and sending messages of pain and discomfort to the brain. Piper and Vane later discovered that this prostaglandin had an effect similar to a known enzyme responsible for the contraction of nonvascular smooth muscle. Further studies demonstrated that aspirin minimized some effects of vasodilation response, ultimately leading Vane to consider that aspirin was inhibiting the synthesis of prostaglandins. For Vane’s pioneering work he, along with Sune K. Bergström and Bengt I. Samuelsson, received the Nobel Prize in Physiology or Medicine in 1982.